Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “NETHERLANDS”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,117 records · Page 62Linked to original sources
PubMed1996

[Costs due to osteoporosis-induced fractures in The Netherlands; possibilities for cost control].

OBJECTIVE: Evaluation of the medical costs of osteoporotic fractures in the Netherlands and a discussion of the possibilities of cost control. DESIGN: Cost calculation using published data combined with data from routine hospital and nursing home registration. SETTING: The Netherlands. METHODS: We estimated the total cost of osteoporosis related to fractures of the hip, forearm and vertebrae. Incidence data and data from hospital and nursing home stays were related to information about costs. The analysis was performed for men and women aged 50 and older based on data from 1993. The validity of the assumptions was tested in a sensitivity analysis. RESULTS: The direct medical cost of osteoporosis-related fractures was estimated to be over 400 million builders each year. More than one-third of this cost originated in the group aged 85 and over, while this group only represented 1.3% of the population. About 85% of the costs were caused by hip fractures. Of those costs of hip fractures 80% was due to the hospital admissions. The length of stay in the hospital was associated with discharge status (the length of stay for patients going to a nursing home was almost 8 days longer than for patients leaving for their own homes) and age (the length of stay increased by 0.3 days/year of age). The cost of the stay in a nursing home and of ambulatory care were 20% and 10%, respectively, of the total costs. CONCLUSION: In the short term, cost control is mainly possible by reducing the length of stay in the hospital. This can be done by providing better methods of discharge to suitable care facilities. The cost-effectiveness of prevention of fractures is at present unclear. Due to the duration of the treatment and the frequency of fractures at high ages, the timing of the intervention is of great importance.

Aged↗
PubMed1996

Decline of coronary heart disease mortality in The Netherlands from 1978 to 1985: contribution of medical care and changes over time in presence of major cardiovascular risk factors.

OBJECTIVE: To study the relative contributions of medical care and changes in cardiovascular risk factors to the decline in coronary heart disease (CHD) mortality in The Netherlands from 1978 to 1985. METHODS: The number of potential CHD deaths prevented in this period was estimated by subtracting the number of observed CHD deaths from the number of deaths that would have occurred without any change in age-specific CHD mortality. In addition, the number of myocardial infarctions over this period was determined. Using estimates of risk associated with smoking, based on national and international data, of effects of changes in total cholesterol level, of benefits of antihypertensive drug treatment and effects of different intervention strategies in subjects with a previous myocardial infarction, we calculated the relative contribution of the separate factors to the decline in CHD mortality. RESULTS: The estimated contribution of treatment in coronary care units, postinfarction treatment and coronary bypass grafting to the fall in CHD mortality was 46%. Approximately 44% of the decline in CHD mortality could be attributed to primary prevention efforts (cessation of smoking, change in cholesterol level and treatment of hypertension). CONCLUSION: On the basis of available estimates of the potential effects of primary and secondary prevention it seems likely that a sizeable proportion of the age-specific reduction in mortality in The Netherlands during the period 1978-85 could have resulted from these measures. However, our findings should be considered to be estimates illustrating the relative benefits of different strategies rather than absolute figures.

Adrenergic beta-Antagonists↗
PubMedDate not supplied

Primary biliary cirrhosis (PBC) in an European country--a description of death rates in The Netherlands (1979-1992).

BACKGROUND/AIMS: In 1979, separate liver transplantation (LT) and primary biliary cirrhosis (PBC) death rate registration became available in The Netherlands (15 million inhabitants). The objective of this study was to investigate death rates from 1979-1992 and analyse the impact of LT. PATIENTS AND METHODS: PBC was either a primary or secondary cause of death. Rates were expressed as absolute numbers or per million inhabitants in the corresponding age category. Age classes of 5 years were used. The Netherlands was divided in four regions, North, South, East and West. Standardized mortality ratios (SMR) were used for calculation of regional differences. RESULTS: In the 14 year period between 1979-1992, 417 persons died from and 179 persons died with PBC, totaling 596 PBC patients (6.3 per million inhabitants > or = 35 years). No person younger than 35 died. Eighty-two percent were female, with a corresponding female/male ratio of 4.2 per million females/males inhabitants. In region South there were significantly fewer deaths (SMR 66%, p < 0.001) and in region North significantly more (SMR 141%, p < 0.05). The median age class at death was 70-74 (males and females alike). At age 35-59, death from PBC in 1992 per million was 1.2, and for > or = 65 years 15.7. In age class 80-84, the highest death rate from or with PBC was found with 28 deaths per million inhabitants and with a female/male ratio of 3.6. In 1992, with two deaths only, LT appeared to have nearly eliminated death from PBC in the age category 35-59 years. CONCLUSION: Death from PBC mainly occurs in the old and very old, who may never seek a specialized center. This indicates a more specific management and therapy for this particular group is needed.

Adult↗
PubMed1996

Forty years of evolution of mortality in Belgium and The Netherlands.

Age adjusted mortality in Belgium (B) and The Netherlands (NL) was calculated from 5 yearly age-specific death rates between the ages 45-74 and 75-85+ years. Mortality was available in Belgium from 1954 to 1991 or 1994 (depending on the cause of death) and from 1950 to 1993 in The Netherlands. In the 45-74 years age class all-cause mortality decreased in B between 1955 and 1992 with 33% in men and 48% in women. In NL this was 11% and 40%, respectively. In the age class 75-85+ it was 21% and 37% in B, and 4% and 36% in NL, respectively. Since 1980 to the last available year there was a marked decrease in mortality in the age class 75-85+ years in men and women from B and no change in NL. Wallonia always had the highest mortality, followed by B, Flanders and NL. However, recently the observed mortality in Flanders was the lowest. Mortality trends, in both age classes and sexes, were obtained between 1980 to the last available year for 11 causes of death in men and 13 in women. Among 48 possible comparisons, 38 (79%) were in favor of B, 9 in favor of NL and 1 ex aequo. Life expectancy in 1992 was compared in the 15 EU countries. For both sexes together B ranked 8th, NL 3rd. The difference in life expectancy between the two countries was 3 year in 1967 and 1 year in 1992. Flanders ranked 5th (0.3 year lower than NL) and Wallonia 14th (2.2 years lower) when substituted for B in the EU. Portugal had the best and Denmark had the worst results between 1967 and 1992). Changes in life style-fat, salt, fruit and vegetable intake and smoking habits -which occurred since 1960 in B, its regions and in NI are consistent with the changes in mortality and life expectancy. Curative medicine and medical technology cannot explain the observed differences and trends.

Adult↗
PubMed1995

Prevalence and trends of obesity in The Netherlands 1987-1991.

OBJECTIVE: To study the prevalence and trends in obesity in the period 1987-1991. DESIGN: Linear regression of average body mass index (BMI in kg/m2) and prevalence of obesity (BMI > or = 30 kg/m2) in a continuous monitoring project in three towns in The Netherlands. RESULTS: It was estimated that over the whole period the prevalence of obesity was 7% in men and 9% in women. After adjustment for age and educational level the prevalence of obesity increased significantly in both men with about 1.7 percentage points (+/- standard error: 0.8) and in women with 1.9 +/- 0.8 percentage points between 1987 and 1991. When stratified by 10-year age category the increase was strongest in those aged 20-29 and 50-59 years. When stratified by educational level, the increase was only significant in the lowest category (primary education and lower secondary education) and was not significant in other categories. CONCLUSION: Obesity is relatively common in The Netherlands and, at least among responders to the yearly surveys, the prevalence of obesity has increased in the period 1987-1991 particularly in those with a relatively low educational level.

Adult↗
PubMed1996

[Medical disciplinary jurisprudence in The Netherlands; a 10-year review].

OBJECTIVE: To obtain information about the nature and the number of complaints, the complainants and the accused health professionals and about the sanctions imposed by the Dutch medical disciplinary courts. DESIGN: Descriptive, retrospective study. SETTING: Inspectorate for Health Care, Rijswijk, the Netherlands. METHODS: All verdicts (n = 5333) given by the 5 medical disciplinary courts of first instance in the period 1983-1992 and the appeals arising from these verdicts were studied using the data of the Inspector in chief. These were related to the total number of practising clinicians obtained from the Inspectorate, the Royal Dutch Medical Association and Statistics Netherlands. The year of each verdict was noted, the number and nature of the verdicts, the categories of complainants and accused, the number of appeal cases and their consequences. RESULTS: The number of complaints doubled in the period under study, rising from 379 to 720 per annum. Most of the complaints (92%) were against doctors, but the number of complaints were divided very unevenly over the clinical specialists. A large number of the complaints concerned 'lack of care or inadequate care' (27%), or 'incorrect treatment' (22%). Of all complaints 20% led to a sanction, mostly a warning (62%). Appeals were lodged against 29% of the verdicts. In 22 cases the licence to practice was withdrawn definitively. CONCLUSIONS: Although the number of complaints increased over the study period, there was no reduction in the seriousness of the complaints. The effect of the disciplinary jurisdiction on the quality of care has not yet been adequately investigated.

Humans↗
PubMed1997

[Cost-effectiveness of influenza vaccination The Netherlands].

OBJECTIVE: To determine the cost-effectiveness of influenza vaccination of all people aged 65 or over in the Netherlands. DESIGN: Model calculations. SETTING: National Institute of Public Health and Environment, Bilthoven, the Netherlands. METHOD: The cost-effectiveness of vaccination strategies was calculated using a mathematical model, with which the epidemiological effects in terms of morbidity and mortality as well as the direct costs of care of an influenza epidemic can be determined. The cost-effectiveness of non-intervention, of the current vaccination scenario for risk groups, and of an alternative scenario involving vaccination of all persons aged 65 or over and of all younger persons in risk groups, was calculated. RESULTS: Influenza-related care (the number of GP contacts and hospital days) and related costs decreased more with the alternative than with the current risk group scenario. Although the costs of care decreased when more people were vaccinated, the cost of vaccination increased more so that total net costs rose (55 million guilders versus 24 million). In the alternative scenario yearly 1115 life years more were won than with the current practice. CONCLUSION: Vaccinating all risk groups and all persons aged 65 or more has a favourable cost-effect ratio in comparison with other preventive intervention programmes.

Adult↗
PubMed1997

Euthanasia in family practice in The Netherlands. Toward a better understanding.

OBJECTIVE: To describe the incidence of euthanasia and assisted suicide in family practice in the Netherlands, the reasons for its practice, and the characteristics of patients and physicians involved. DESIGN: Cross-sectional survey of a random sample of Dutch family physicians. SETTING: General practices in The Netherlands. PARTICIPANTS: An anonymous questionnaire was mailed to 1042 general practitioners. Of the 996 eligible physicians, 667 (67%) completed the questionnaire. MAIN OUTCOME MEASURES: Reported practices and beliefs concerning euthanasia and assisted suicide. RESULTS: In the course of an average year, 24% of Dutch family physicians had practised euthanasia or assisted suicide. Most deaths took place at home in the presence of others. According to the physicians, the most important reasons for the request were futile suffering, fear or avoidance of loss of dignity, and unbearable suffering. Euthanasia or assisted suicide was mostly (85%) administered to patients with malignant neoplasms. Physicians were more opposed to euthanasia and assisted suicide if they had never practised it, if they had a religious affiliation, and if they were older. CONCLUSIONS: This study presents empiric data about euthanasia and assisted suicide in the context of a permissive euthanasia policy. Understanding Dutch practices could be helpful for Canadians. However, each country needs to resolve these issues in its own way.

Adult↗
PubMed1977

Referrals and demand for specialist care in the Netherlands.

Three independent sets of data are analyzed to investigate the determinants of referrals from general practitioners to specialists, the demand for specialist care, and the rapid increase in referrals and use of specialists in the Netherlands. Individual determinants of demand are examined with data from a three-man group practice; macroanalyses are conducted on cross-section data from all service areas of the Dutch Sickness Fund Organization for 1971 and 1973 and cross-section time-series data from all provinces for the period from 1960 to 1972. Regression coefficients are estimated for the number of referrals to specialists and the amount of care given by specialists, with respect to explanatory variables that induce both socioeconomic and care-supply factors. Results are discussed in light of M. Feldstein's classification of three types of care, in which for some types the physician is seen as generating the demand for care. The authors conclude that demand for specialist outpatient care is in large part supply-determined and that general practitioners substitute for specialists; they also suggest that the dual physician-payment system in the Netherlands (capitation for legally insured patients and fee-for-service for privately insured patients) contributes to increased use of specialist care.

Ambulatory Care↗
PubMed1997

Site, histological type, and thickness of primary cutaneous malignant melanoma in western Netherlands since 1980.

An increasing incidence of cutaneous malignant melanoma had been observed in the Netherlands. Therefore, between 1989 and 1992 a preventive skin cancer campaign was organized in part of western Netherlands. The effect of this screening campaign has yet to be evaluated by investigating the distribution of all in situ and invasive primary cutaneous melanoma according to anatomical subsite, tumour thickness, and histological type in a population-based study during 1980-92. A total number of 2236 (1361 female; 875 male) invasive and 580 (395 female; 185 male) in situ melanomas were diagnosed. The median age of patients with thin lesions was 46 years, intermediate lesions 54 years, and thick lesions 65 years, which may be indicative of slow tumour progression. The median thickness of the invasive lesions was 0.9 mm for women and 1.1 mm for men and the invasive to in situ ratio was 3.4 for female and 4.7 for male subjects, suggesting a reasonable awareness of melanoma in this population. The relative tumour density (RTD) was remarkably high for melanomas in the head/neck area for both sexes and invasive melanoma on the male trunk and the lower legs of females. The low RTD of invasive melanomas on the lower limbs of men and the high density in the head/neck area for both sexes are remarkable and support the aetiological role of ultraviolet exposure. It is concluded that our findings are in many ways similar to those of other descriptive studies.

Adolescent↗
PubMed1997

[A uniform protocol for liver transplantation in adults in The Netherlands].

Recently a common protocol for liver transplantation in adult patients was established in the two officially registered liver transplantation centres in the Netherlands, Groningen University Hospital and Rotterdam University Hospital. Although the total number of liver transplantations is steadily increasing in the Netherlands, the number of 85 in 1996 is still far below the estimated required number of 150 per year (10 per million of the population per year). If the current trend continues, the number of performed liver transplantations will reach an optimal level in a few years' time, however. The present uniform protocol prevents patients being referred for liver transplantation too early or too late.

Academic Medical Centers↗
PubMed1997

[AIDS epidemic in The Netherlands: current developments in transmission route, age and nationality].

OBJECTIVE: To document the recent developments in the course of the AIDS epidemic in the Netherlands, 1982-1995. DESIGN: Descriptive. SETTING: National Institute of Public Health and Environment, Bilthoven, Municipal Health Service, Amsterdam, and Inspectorate of Public Health, Rijswijk, the Netherlands. METHOD: Based on the new AIDS patients reported to the Inspectorate of Public Health, the incidence figures were calculated by risk group (homo/bisexual men, intravenous drug users and heterosexual men and women), by birth cohort defined by 5 successive years of birth, and by nationality, in order to characterise sub-epidemics. RESULTS: Among homo/bisexual men AIDS incidence has been stabilizing in recent years. Among intravenous drug users and heterosexuals incidence continues to rise but at a low level compared with homo/bisexual men. Among homo/bisexual men and intravenous drug users mean age at AIDS diagnosis is rising in conjunction with reduced incidence among young persons born in 1965-1969 when compared with the incidence among persons born in 1960-1964 when at the same age. By contrast, among heterosexuals a decline in mean age at diagnosis is observed and this decline coincides with undiminished rise of incidence among persons born in 1965-1969. Among heterosexual patients an increasing and disproportionate number have the nationality of a sub-Saharan African country. CONCLUSION: Future AIDS incidence among homo/bisexual men and intravenous drug users will probably be lower than it currently is. Regarding heterosexuals the undiminished growth of the number of young AIDS patients and the increasing proportion of patients from abroad make such an assessment more difficult.

Acquired Immunodeficiency Syndrome↗
PubMed1996

Hospital hygiene in Europe. The situation in Belgium and The Netherlands.

The situation of hospital hygiene in Belgium and in the Netherlands is described in the light of the official regulations, the composition and the functioning of the infection committee and of the hospital hygiene team, and the availability of official or semi-official guidelines. Typical for the Netherlands in the long tradition of issuing guidelines on hospital hygiene, in the beginning in 1966 in the form of an advice of the Health Council, at present in the guidelines of the Working Group on Infection Prevention (WIP). A particularity for Belgium is the financing by the state of the hospital hygiene doctor and the hospital hygiene nurses based on a system of scores in which the beds of specialisms with a higher infection risk count for more than general beds.

Belgium↗
PubMed1997

Acute work-related poisoning by pesticides in The Netherlands; a one year follow-up study.

The National Poisons Control Centre of the National Institute of Public Health and the Environment in the Netherlands conducted a prospective study on acute poisoning arising from exposure to pesticides in agricultural workers. The study was performed to determine the extent and severity of acute pesticide poisoning in the Netherlands and the working conditions that lead to these poisonings. All cases of potential acute occupational intoxication by pesticides in which the Poisons Control Centre was consulted in 1991 were thoroughly studied by an occupational hygienist and a specialist in internal medicine. With the consent of the patients and their physicians, the patients' medical condition and the working conditions leading to exposure were investigated on the spot. After the exclusion of 73 patients (27 non-occupational exposures, 7 occupational exposures in non-agricultural workers, 1 accident occurred abroad, 32 patients with illnesses unrelated to pesticides and 6 who could not be traced for follow-up), 54 cases of possible acute work-related pesticide poisoning remained for study. In 37 of the 54 events there was a direct relation between exposure to pesticides and acute health problems. In one patient doubt remained about the origin of the complaints and in 16 of the 54 cases pesticide poisoning was highly unlikely and the complaints could be attributed to other diseases. In the 37 remaining cases symptoms consisted of skin and/or eye lesions (23 cases) and systemic health effects (14 cases). Exposure to the soil disinfectant 1,3-dichloropropene resulted in severe skin damage. Direct contact of pesticides with the eyes invariability resulted in local irritation. Severe systemic poisonings occurred after exposure to organophosphate and carbamate insecticides and the soil disinfectant methyl bromide. Investigations at the site of the exposure revealed 43 cases of clear exposure to pesticides, in which, except for two cases, 1 worker per incident was involved. In 67% of the cases exposures took not place during pesticide dissemination, but during preparatory activities (35%), repair of application equipment (14%) and during re-entry (14%). In 79% of the cases splashing of pesticides or spray drift led to the exposure. In most accidents (74%) imperfect technical design or technical defects were important risk factors for exposure. Although most workers were aware of the risk of using pesticides, they were still careless in taking adequate protective measures. Especially during preparatory and reparations activities the wearing of protective clothing has to be emphasized.

Adolescent↗
PubMed1997

[Parental participation in residential treatment in the Netherlands].

Comparable with the situation in other countries it has become a generally accepted principle in the Netherlands to involve parents as much as possible in the treatment process of children with emotional and behavioural disturbances, who have been placed in residential care. After discussing the reasons for this, we explore the ways in which parents can be involved in practice. Next, we show some results from recent research in the Netherlands, in which the actual participation of parents in the residential treatment of their son or daughter was investigated. It can be concluded that the involvement is limited. The results also show the central position of the group worker concerning parent contacts. We advocate more attention to the activities of this discipline with parents--in research as well as in practice.

Adolescent↗
PubMed1996

[Towards congruence in nursing information provision in The Netherlands].

Few reliable data are available about nursing care in the Netherlands, whereas pressure from society to support the contributions of the discipline of nursing to health care delivery increases. This paper presents an information model to support analytical access to nursing labour and services. This model, the nursing information reference model (Dutch acronym 'VIRM') focuses on the structure to achieve congruence between data from the primary process of nursing care and data derived from that process for clinical practice, management, research, and policy purposes. The model is based on the 'collect-once/use-often' principle of data collection and management, which emphasizes single collection and registration through the patient record for multiple subsequent uses and purposes. In this paper core elements of the VIRM are being discussed. Determination of data from the primary process of nursing care to be provided for certain aims is currently being conducted by the Dutch Nursing Minimum Data Set (VMDNS) initiative. The article at issue should be understood as a starting point in the discussion about the development of a Nursing Minimum Data Set in the Netherlands.

Data Collection↗
PubMed1997

[HIV/AIDS in The Netherlands: improved treatment possibilities necessitate HIV instead of AIDS surveillance].

An abrupt decrease of the number of reported new AIDS cases took place in the first half of 1997 in the Netherlands. This decrease was most prominent in homosexual/bisexual men and intravenous drug users, and less conspicuous in heterosexual men and women. The number of heterosexual patients with a non-Dutch nationality even increased compared with the first half of 1996. The most probable explanation of these observations is the introduction of improved treatment possibilities for HIV-infected people starting July 1996, which lead to a longer incubation period. Owing to these developments monitoring the HIV/AIDS epidemic in the Netherlands will depend more and more on HIV status surveillance instead of on registration of new AIDS cases.

Anti-HIV Agents↗
PubMed1997

[The first Nassaus in The Netherlands: identification of and paleopathological findings in Willem van Oranje's ancestors, buried in the Grote Onze Lieve Vrouwe Kerk in Breda].

OBJECTIVE: Identification and paleopathological analysis of the remains of the first members of the Nassau dynasty in the Netherlands. DESIGN: Descriptive. SETTING: Centre for Physical Anthropology 'Barge's Anthropologica', Leiden University. METHODS: In 1996, seven interments were discovered in situ in a tomb under the Nassau monument of the so-called 'Grote' or 'Onze Lieve Vrouwe' Church of the city of Breda. The interments were excavated and examined by osteological analysis, X-ray analysis, accelerator mass spectrometry (AMS) 14C dating of bone and dendrochronological dating. RESULTS: Evaluation of archaeological, osteological, dendrochronological and AMS 14C-dating data resulted in identification. in order of death, of: Engelbrecht I van Nassau (ca. 1370-1442 AD), Johanna van Polanen (1392-1445 AD), Jan IV van Nassau (1410-1475 AD), Cimburga van Baden (1450-1501 AD), Maria van Loon (1425-1502 AD), Engelbrecht II van Nassau (1451-1504 AD) and Françoise van Savoye ((1480-1486)-1511 AD). Remarkable medical findings were: embalming procedures employed (skull cap detachment, removal of viscera), treponematosis (Engelbrecht II), tumour metastases (Jan IV) and scoliosis (Françoise van Savoye). CONCLUSION: The methods employed resulted in positive identification of the first members of the Nassau dynasty in the Netherlands and diagnoses of their paleopathological changes.

Embalming↗